News - February 2010

Contents
NICE publishes guideline on prophylactic treatment of VTE Management of depression: non-pharmaceutical treatments Standards for the management of STIs have been launched The National Audit Office has published a report on dementia services in England The RCGP has updated its Guide to the revalidation of general practitioners

NICE publishes guideline on prophylactic treatment of VTE

A new guideline from NICE aims to save thousands of lives by preventing blood clots in hospital patients. Venous thromboembolism: reducing the risk focuses on reducing deep vein thrombosis (blood clots blocking the veins, also known as DVT) in patients admitted to hospital. If the blood clot travels to the lungs it can cause a potentially fatal pulmonary embolism. An estimated 25,000 people admitted to hospital die each year from preventable venous thromboembolism (VTE). The NICE guideline aims to reduce this number by recommending that all patients are assessed for the risk of developing blood clots when first admitted to hospital, and then given preventive treatment to meet their individual needs. The guideline covers both DVT and possible pulmonary embolisms and includes recommendations on:

Using VTE prophylaxis
Assessing the risks of VTE and bleeding
Medical and surgical patients
Patient information and planning for discharge.

Prophylactic options include:

anti-embolism stockings (thigh or knee length)
foot impulse devices
low molecular weight heparin
unfractionated heparin
intermittent pneumatic compression devices (thigh or knee length)
fondaparinux sodium.

Dr Fergus Macbeth, Clinical Director at NICE said: ‘It has been reported that measures to prevent VTE in hospital patients are used inconsistently, and in many cases patients at significant risk of developing a blood clot don’t get any preventative treatment at all.’

www.nice.org.uk

Management of depression: non-pharmaceutical treatments

A guideline on the non-pharmaceutical management of depression in adults has been published by SIGN.

The most common intervention for depression is antidepressant medication, but feedback from service users has highlighted the need for robust information about alternatives to prescribed pharmacological options. The SIGN guideline examines psychological therapies, exercise and lifestyle interventions, and complementary and alternative treatments, many of which are not routinely available at the NHS. The guideline includes recommendations on:

behavioural activation
individual cognitive behavioural therapy (CBT)
interpersonal therapy
problem-solving therapy
guided self help based on CBT or behavioural principles
computerised CBT within the context of guided self help
structured exercise.

www.sign.ac.uk

Standards for the management of STIs have been launched

The British Association of Sexual Health and HIV and the Medical Foundation for AIDS & Sexual Health have produced new standards for the management of sexually transmitted infections (STIs). These will support the commissioning and provision of high-quality care for STIs across all care settings. The nine standards cover the following areas:

Principles of STI care
Appropriately trained staff
Clinical assessment
Diagnostics
Clinical management
Information governance
Links to other services
Clinical governance
Patient and public engagement.

Each standard is accompanied by a rationale, outcome-focused implications for commissioning, key performance indicators, and supporting information.

www.bashh.org

The National Audit Office has published a report on dementia services in England

It assesses the robustness of the National dementia strategy and the steps needed for successful implementation.

www.nao.org.uk

The RCGP has updated its Guide to the revalidation of general practitioners

To accompany this, version 2 of the RCGP guide to the credit-based system has also been released.

www.rcgp.org.uk

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